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Clinical impact of the CONUT score in patients with multiple myeloma.
Annals of Hematology ( IF 3.0 ) Pub Date : 2019-11-25 , DOI: 10.1007/s00277-019-03844-2
Sho Okamoto 1, 2 , Hiroshi Ureshino 1, 3 , Keisuke Kidoguchi 1 , Kana Kusaba 1 , Haruna Kizuka-Sano 1 , Haruhiko Sano 1 , Atsujiro Nishioka 1 , Kyosuke Yamaguchi 1 , Kazuharu Kamachi 1 , Hidekazu Itamura 1 , Mariko Yoshimura 1 , Masako Yokoo 1 , Takero Shindo 1, 4 , Yasushi Kubota 1 , Toshihiko Ando 1 , Kensuke Kojima 1 , Atsushi Kawaguchi 5 , Eisaburo Sueoka 6, 7 , Shinya Kimura 1, 3
Affiliation  

Novel anti-myeloma drugs have significantly improved the overall survival (OS) of patients with multiple myeloma (MM). However, not all MM patients treated with these drugs show survival benefits, and biologic and genetic prognostic factors are insufficient to predict the response to treatment. Decreasing treatment-related complications is important to improve the efficacy of treatment in patients with MM. The Controlling Nutritional Status (CONUT) score is a screening method for poor nutritional status, which is associated with poor prognosis in several cancers because it increases the rate of treatment-related complications. We retrospectively analyzed the OS of 64 patients with symptomatic MM and evaluated the correlation between the CONUT score and patient prognosis in MM. The median age at diagnosis was 66 years, and multivariate analysis showed that a high CONUT score (≥ 5; hazard ratio, 3.937; 95% confidence interval, 1.214-12.658; P = 0.022) was an independent prognostic risk factor. Subgroup analysis was performed according to patient age because the choice of treatment strategy, particularly autologous peripheral blood stem cell transplantation (auto-PBSCT), can vary depending on age in MM patients. Younger patients (< 65 years old) who received auto-PBSCT and had a lower CONUT score (0-3) showed a significantly better survival outcome than those with a higher CONUT score (≥ 4) (median OS, not reached vs. 64.1 months; P = 0.011). The CONUT score is simple to calculate and provides a useful prognostic indicator in patients with MM, especially transplant-eligible patients.

中文翻译:

CONUT评分对多发性骨髓瘤患者的临床影响。

新型抗骨髓瘤药物已显着改善了多发性骨髓瘤(MM)患者的总体生存率(OS)。然而,并非所有使用这些药物治疗的MM患者都显示出生存获益,并且生物学和遗传预后因素不足以预测对治疗的反应。减少与治疗相关的并发症对于提高MM患者的治疗效果非常重要。控制营养状况(CONUT)评分是一种营养状况不佳的筛查方法,其与几种癌症的预后不良有关,因为它增加了治疗相关并发症的发生率。我们回顾性分析了64例有症状MM患者的OS,并评估了CONUT评分与MM患者预后之间的相关性。诊断时的中位年龄为66岁,多因素分析显示,较高的CONUT评分(≥5;危险比为3.937; 95%置信区间为1.214-12.658; P = 0.022)是独立的预后危险因素。根据患者年龄进行亚组分析,因为治疗策略的选择(尤其是自体外周血干细胞移植(auto-PBSCT))可能会因MM患者的年龄而异。接受自动PBSCT且CONUT评分较低(0-3)的年轻患者(<65岁)与CONUT评分较高(≥4)的患者相比,其生存结局明显更好(中位OS,未达到64.1。月; P = 0.011)。CONUT评分易于计算,可为MM患者(尤其是适合移植的患者)提供有用的预后指标。1.214-12.658;P = 0.022)是独立的预后风险因素。根据患者年龄进行亚组分析,因为治疗策略的选择(尤其是自体外周血干细胞移植(auto-PBSCT))可能会因MM患者的年龄而异。接受自动PBSCT且CONUT评分较低(0-3)的年轻患者(<65岁)与CONUT评分较高(≥4)的患者相比,其生存结局明显更好(中位OS,未达到64.1。月; P = 0.011)。CONUT评分易于计算,可为MM患者(尤其是适合移植的患者)提供有用的预后指标。1.214-12.658;P = 0.022)是独立的预后风险因素。根据患者年龄进行亚组分析,因为治疗策略的选择(尤其是自体外周血干细胞移植(auto-PBSCT))可能会因MM患者的年龄而异。接受自动PBSCT且CONUT评分较低(0-3)的年轻患者(<65岁)与CONUT评分较高(≥4)的患者相比,其生存结局明显更好(中位OS,未达到64.1。月; P = 0.011)。CONUT评分易于计算,可为MM患者(尤其是适合移植的患者)提供有用的预后指标。特别是自体外周血干细胞移植(auto-PBSCT),可能会因MM患者的年龄而异。接受自动PBSCT且CONUT评分较低(0-3)的年轻患者(<65岁)与CONUT评分较高(≥4)的患者相比,其生存结局明显更好(中位OS,未达到64.1。月; P = 0.011)。CONUT评分易于计算,可为MM患者(尤其是适合移植的患者)提供有用的预后指标。特别是自体外周血干细胞移植(auto-PBSCT),可能会因MM患者的年龄而异。接受自动PBSCT且CONUT评分较低(0-3)的年轻患者(<65岁)与CONUT评分较高(≥4)的患者相比,其生存结局明显更好(中位OS,未达到64.1。月; P = 0.011)。CONUT评分易于计算,可为MM患者(尤其是适合移植的患者)提供有用的预后指标。
更新日期:2019-11-01
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